Healthcare providers’ motivations and challenges when communicating about sexual health with individuals with intellectual disabilities

Abstract

Patients with intellectual disabilities face additional challenges due to fears of health literacy (i.e., the ability to seek, understand, and utilize health information) and communicative competence. The taboo nature of sex has limited the communication surrounding sex for individuals with intellectual disabilities, including education, prevention, biological components, disease, and more. The limited communication about sexual health and the more significant challenges present when communicating have placed individuals with intellectual disabilities at a higher risk for sexual consequences. The current study examines providers’ motivations and motivators when communicating with individuals with intellectual disabilities about sexual health to understand the role healthcare providers contribute. Nine healthcare providers were recruited for the current study; participants included OBGYN, family medicine, and women’s healthcare physicians. Data was collected from semi-structured interviews lasting 30-45 minutes, asking participants about their experiences in the clinic while communicating with patients with intellectual disabilities. Data was gathered using audio recording and transcribed to be coded using grounded theory methods presented by Charmaz (2014). Findings suggest that providers communicate with patients with intellectual disabilities about sexual health when one of three motivations exists within a clinical. The motivators for providers are patient initiation, provider observation, and normative practices, which initiate the conversation about sexual health. After initiating the conversation, five contextual factors exist to determine how the provider communicates with patients with intellectual disabilities. The four motivators are patient cognitive abilities, patient verification, third-party verification, and provider interpretation. Potential future directions for the current findings are continued research examining patients with intellectual disabilities, the ability to initiate the conversation the motivators when enacted by individuals with intellectual disabilities.